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09 November 2023 | Story André Damons | Photo SUPPLIED
UFS experts give presentations on hospital-acquired infections at Africa Health
From left (bottom) Samantha Mc Carlie, Prof Robert Bragg and Caroline Bilen. (Back) Hugo La Reserve (from PMB Health and Safety) and Dr Noor Zakhura (from Free State Department of Health) at the Africa Health Exhibition.

It was recently discovered that bacteria are capable of growing inside bottles of disinfectants, hand sanitisers and antiseptics. These cleaning products, which are actively used in South African hospitals, are doing more harm than good by contaminating the environment they are designed to clean. Upon testing, some of these contaminated bottles harbouring harmful microorganisms were still actively in use in hospitals and instead of killing microorganisms, the contaminated cleaning solutions were spreading pathogens throughout the hospital with their use. 

This is according to Samantha Mc Carlie from the Department of Microbiology and Biochemistry at the University of the Free State (UFS). She, with her promotor, Prof Robert Bragg, were part of a workshop at the Africa Health Exhibition – the biggest gathering of health care professionals in South Africa and Africa. This was held at Gallagher Estate, Midrand, from 17 to 19 October 2023. 

Increasing mortalities in health-care setting

In a workshop titled: “Developing and sustaining safe health-care environments”, they were part of the main presenting panel, together with Caroline Bilen from the Compass Health Consultancy in Dubai 

Prof Bragg, whose main research is in disease-control, first in the agricultural industry, and now human health, started off the session by highlighting the problems with the increasing mortalities in the health-care setting. He presented data indicating that in the not too distant future, deaths from hospital-acquired infections would be the leading cause of human deaths. “This problem is rapidly growing as most of the pathogens which people contract while in hospital are now resistant to antibiotics, making them very difficult to treat,” he explained.

He used an analogy from San Tzu from the book The Art of War to explain why humankind is losing the war against the microbes. “San Tzu stated that if you know yourself and know your enemy, you will be victorious in every battle. On the other hand, if you do not know yourself or the enemy, you will be defeated in every battle. He pointed out that we do not know the enemy and we do know ourselves (or rather the weapons we have to defeat the enemy) and for this reason we are being defeated,” according to Prof Bragg. 

He continued: “We know the names of the different pathogens causing diseases, but do we really understand them? The answer to that must be ‘no’. A typical example is people are using ethanol-based or chlorine-based products to disinfect and then they wonder why there are increasing problems with Clostridioides difficile infections. If we knew the enemy, we would know that this bacterium producers endospores  and chlorine and ethanol-based disinfectants do not inactivate bacterial endospores, and so will not kill this bacterium,” said Prof Bragg. 

He stated that a major concern for hospitals is that they are currently unaware of whether the disinfectants they are using are effective against the pathogens in their hospital. It is assumed that their cleaning products are working but no testing is being done.

Bacterial resistance to disinfectants

Mc Carlie, in her presentation, highlighted the development of bacterial resistance to disinfectants and why this is important in the health-care setting. She pointed out that the standards for the registration of disinfectant products is based on the use of reference strains of bacteria.

“Bacteria found in hospital environments often exhibit significantly greater resistance to disinfectant compounds compared to the standard strains used for product testing. The presence of these resistant bacteria can result in microbial growth and contamination within containers of disinfectants, hand sanitisers, and antiseptics intended for hospital cleaning purposes. Instead of effectively eliminating microorganisms, these contaminated products inadvertently spread these resilient bacteria throughout the hospital environment, contributing to overall contamination,” said Mc Carlie.

She also discussed the consequences of using incorrectly diluted disinfectant products at concentrations that will not be effective against resilient hospital pathogens. 

Prof Bragg finished the session with a discussion on the solutions to the current problem and highlighted the need for a paradigm shift in medicine. “The current paradigm, since the discovery of antibiotics, has been treatment. As we are entering into a post-antibiotic era, this paradigm of treatment needs to change to one of ‘prevention’. The old saying ‘Prevention is better than cure’ has never been more true.”

He concluded by discussing various options which could be used when focus is placed on biosecurity for the prevention of hospital-acquired infection; including the installation of UV lights, monitoring of the laundry process, correct disinfecting of surfaces, using products with proven efficacy against the pathogens isolated from the different health-care setting and finally, the use of antimicrobial bedside privacy curtains.

The workshop ended with a panel discussion on biosecurity and the efforts needed to reduce the ever-increasing numbers of hospital-acquired infections. It is hoped that the message of this workshop will have a significant impact on the reduction of hospital acquired infections. 

Click to view documentProf Bragg's presentation.

Click to view documentMc Carlie's presentation.

News Archive

Doll parent project exposes learners to real-life issues of responsible reproductive health
2016-11-01

Description: Doll parent project  Tags: Doll parent project

Princess Gaboilelwe Motshabi,
Princess Gabo Foundation, Maki Lesia,
School of Nursing, Zenzele Mdletshe,
Internationalisation office, Masters of
Education students from Rutgers University
and study leader.


With the alarming rate of teenage pregnancies in secondary schools, a concerned teacher approached University of the Free State (UFS) School of Nursing in 2013, and in 2015, the Reproductive Health Education Project (RRHEP) was established in collaboration with fourth-year Midwifery students, the Princess Gabo Foundation and the UFS Community Engagement Directorate.

Empowering learners to make responsible reproductive health choices was the primary objective, which got final-year nursing students involved in the Doll-Parenting Project as part of their Service Learning Module. To simulate parenting, boys and girls in Grade Eight were given dolls to take care of as their “baby” for a given period of time. After an information session with parents and guardians, the project took off at Moroka High School in Thaba Nchu and Lekhulong High School in Mangaung. The Princess Gabo Foundation, an NGO operating in the Thaba Nchu community, which supports maternal health programmes, provided the dolls, kangaroo wraps, and diaries in which learners recorded their daily experiences of caring for a baby.

Teen parenting – a challenging experience

Learners were required to calculate how much it would cost to care for a baby, the cost of buying nappies, formula milk (if not breast feeding), doctor’s visits, and medicine. The project was supported by teachers in various subject classes, and learners were encouraged to express themselves through writing of poems or essays about how it feels to be a teen parent.

Dr Delene Botha, lecturer at the School of Nursing, said there was a need to establish a sustainable research project that would attract funding. By adding some of the missing components and drawing on other disciplines such as Sociology and Psychiatry, the project was expected to be extended to meet the needs of other stakeholders including teachers, parents and the community at large.

With cellphones and data provided by the Community Engagement office, the “parenting practice” involved receiving SMS messages from nursing students during odd times of the day to remind them about the needs of the baby; such as wet nappies, the “baby” not feeling well and to be soothed.

Sensitising learners yields success

In evaluating their performance, appointed “police learners” became the eyes and ears of the community to observe and report on how “parents” treated their “babies”. Statements from participants and feedback showed Incidences of negligence and the feeling of embarrassment from being a teen parent. The report indicated that learners felt that having a baby while still at school was not a good idea. The project concluded with a debate on the subject.

As part of the programme, a group of postgraduate Education students from Rutgers University in the US, visited Chief Moroka High School and received first-hand information from their interaction with the learners from which they created digital stories of their Community Engagement experience and took these back with them.

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